Paediatric Case Study on Acute Appendicitis and Nursing Care

Running head: PAEDIATRIC CASE STUDY
PAEDIATRIC CASE STUDY
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PAEDIATRIC CASE STUDY
Acute appendicitis can be defined as the inflammation of the appendix which is
actually a narrow blind ended tube that remains connected to the postero-medial end of the
caecum. It mainly remains associated with abdominal pain and can be described as the
condition which can result in abdominal surgery in the children (Shweiki et al., 2016). This
assignment is also based on the case study where nursing professionals have to care for Anne
who is a 10 year old child who has undergone appendicitis surgery and requires care and
support in the hospital.
Appendicitis occurs due to the inflammation of the inner lining of the vermiform
appendix that gradually spread to other parts of the body. The main reason for its occurrence
is the obstruction of the appendiceal lumen due to a number of purposes. Lymphoid
hyperplasia that takes place secondary to that of the infectious as well as inflammatory
disorders might result in obstruction. Besides, faecal statis and faecaliths might also obstruct
but they are more common in elderly people (Allievi et al., 2017). Bacterial obstructions,
although rare might also occur along with blockage due to foreign materials or due to
neoplasm. These forms of obstructions mainly result in the increasing of pressure within the
lumen. Such increase in the pressures mainly takes place due to the continuous secretion of
the fluids as well as mucus from the mucosa (Hughes & Lu, 2015). Additionally, the
intestinal bacteria within the appendix are also seen to undergo multiplication. This again
leads to the recruitment of the white blood cells as well as the formation of the pus (Flum,
2015). This causes further increase of the intra-luminal pressure and this leads to the
obstruction in the venous outflow. Ischemia is seen to occur in the appendiceal wall and this
situation results in the loss of epithelial integrity as well as bacterial invasion. Researchers are
of the opinion that thrombosis which occurs in the appendicular artery as well as the veins
lead to perforation as well as gangrene of the appendix (Wagner et al., 2018). When this
process is seen to continue, it results in the development of a peri-appendicular abscess. This

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PAEDIATRIC CASE STUDY
might get localized if it gets walled off by the omentum. Alternatively, there might be also
occurrence of a generalized peritonitis (Mak et al., 2016). Fluid mixed with bacteria may get
spilled from the perforation to different art of the abdomen causing severe pain. In the case
study as well, the patient named Anne was admitted to the ward due to right iliac fossa pain
due to occurrence of the appendicitis. It had become perforated with the spread of the
infectious fluid internally in the peritoneum and it had become gangrenous as well.
Therefore, the surgery required removing the organ in order to help the patient get over the
pain.
Jean Piaget had proposed one of the most influential theories concerning cognitive
development which is known as the Piaget's cognitive development theory. This theory
mainly explains the development of different types of thought procedures and mental States
from the time of birth to that of adulthood. It mainly helps in looking at how different types
of thought procedures are able to influence the way individuals understand and thereby
interact with the world (Sieglar, 2016). There are four different stages of this theory out of
which the state which is applicable in the case study is called the Concrete operational stage.
The stage mainly occurs between the period of 7 years age and 11 years age. Researchers
have found that their thinking becomes more logical as well as organized but it still remains
concrete and rigid (Homes et al., 2016). Children are seen to use inductive logic and different
types of reasoning skills from specific information to a General principle (Barrouillet, 2015).
At this stage the egocentrism of the child is seen to disappear and the children start to
understand that the viewpoint of others might not match with the viewpoint of them. In the
case study it is seen that Anne is a child of 10 years. The child might have many concerns
regarding the causes of her suffering and pain that had made her admitted to the hospital
(Lefa et al., 2014). As she would not be having any egocentrism in the stage, the nursing
professional can easily make her understand about the different factors that had made her